Abstract
Aim
The aim of this study is to evaluate the frequency and types of anti-retinal autoantibodies (ARAs) in highly myopic patients and to explore any association between ARAs and the severity of myopic macular degeneration (MMD).
Methods
This was a clinic-based study of 16 patients with high myopia (spherical equivalent worse than −6 dioptres or axial length (AL) ≥ 26.5 mm) recruited from the High Myopia clinic of the Singapore National Eye Centre. MMD was graded from fundus photographs according to the Meta-analysis for Pathologic Myopia (META-PM) classification. Severe MMD was defined as META-PM category 3 or 4. AL and logarithm of the minimal angle of resolution (logMAR) best corrected visual acuity (BCVA) were measured. Sera were obtained from subjects and analysed for the presence of ARAs with the western blot technique.
Results
The mean AL was significantly longer in patients with severe MMD (n = 8) than those without severe MMD (n = 8) (31.50 vs. 28.51, p = 0.005). There was at least one ARA identified in all patients. The most common ARA was anti-carbonic anhydrase II (anti-CAII), present in nine patients (56.3%). Anti-CAII was detected in more patients with severe MMD than those without (75 vs. 37.5%, p = 0.32). LogMar BCVA was also worse in subjects with anti-CAII (0.5 ± 0.38 vs. 0.22 ± 0.08, p = 0.06). The number of ARAs significantly correlated with increasing AL (r = 0.61, p = 0.012).
Conclusions
ARAs are prevalent in patients with high myopia, and this increases with increasing AL. In particular, anti-CAII antibodies were highly prevalent in patients with severe MMD, suggesting that ARAs may be associated with MMD. Further studies are necessary to confirm these observations in larger cohorts.
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Funding
This work was supported by an A-STAR Strategic Positioning Fund (SPF2014/002) to SIPRAD, SERI (Singapore Eye Research Institute), IMCB (Institute of Molecular and Cell Biology) Programme in Retinal Angiogenic Diseases and National Medical Research Council Open Fund Large Collaborative Grant: NMRC/LCG/004/2018 and SNEC HREF—R1375/61/2016.
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Sim, S.S., Wong, C.W., Hoang, Q.V. et al. Anti-retinal autoantibodies in myopic macular degeneration: a pilot study. Eye 35, 2254–2259 (2021). https://doi.org/10.1038/s41433-020-01241-y
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DOI: https://doi.org/10.1038/s41433-020-01241-y
